Sulfonylurea Agents: "Oral Hypoglycemic Agents"

Why do I need Sulfonylurea agents?

Sulfonylurea agents (or oral hypoglycemic agents) are one of six types of diabetes pills currently available to treat type 2 diabetes.

Remember, the cornerstone of diabetes control remains unchanged: it is important to follow a meal plan and get plenty of physical activity. Diabetes pills are simply another tool to help you manage your blood glucose.

There are many different Sulfonylurea agents:

Newer and stronger pills:

Older pills:

Brand name:

Generic name:

Brand name:

Generic name:

Diabeta®

(glyburide)

Diabinese®

(chlorpropamide)

Micronase®

(glyburide)

Orinase®

(tolbutamide)

Glynase Prestab®

(micronized glyburide)

Tolinase®

(tolazamide)

Glucotro1®

(glipizide)

Glucotrol XL®

(glipizide extended release)

Amaryl®

(glimepiride)

How do sulfonylurea agents work?

Sulfonylurea agents work to lower blood glucose by:

Helping the pancreas produce more insulin

Allowing the cells to use insulin better

Guidelines for use:

Take your pills daily, at the same time each day, before meals.

Glucotrol should be taken 30 minutes before eating. Other oral agents should be taken at the meal.

Do not change how many pills you take without asking your healthcare provider.

Oral hypoglycemic agents are often taken in combination with other diabetes pills and/or insulin to further improve your glucose control.

If you take Diabinese, do not use alcohol, because the combination of this medicine and alcohol may cause you to feel dizzy and sick to your stomach. Your face may feel warm and red and you could have severe low blood glucose.

What should I do if I forget to take my dose?

If you have forgotten to take your diabetes pills, take them, provided it has been less than 2 hours from your dosage time. Write down that you delayed a dose in your record book. If it has been more than 2 hours, contact your healthcare provider. Do not take 2 doses at the next meal unless otherwise instructed. If you skip a dose, note it in your record book.

Can I take sulfonylurea agents with other medications?

Most medications interact safely with the newer sulfonylurea agents. However, always remind your healthcare provider what medicines you are taking and when there is a change in your medications. This will help ensure the combinations are safe. Ask if the new medication will affect your diabetes.

What are the side effects of sulfonylurea agents?

Hypoglycemia or low blood glucose is the most common side effect of the sulfonylurea agents.

Other side effects, although uncommon, are listed below. Be sure to contact your healthcare provider if any of the following problems occur while you are taking your sulfonylurea agent:

Skin reaction

Dark urine

Stomach upset (nausea, diarrhea, tendency to pass gas)

Increased sensitivity to sunWho should NOT take hypoglycemic agents?

Some people with kidney or liver disease or with allergies to sulfa drugs

The safety of using sulfonylureas in pregnancy has not been established. If you are planning a pregnancy or become pregnant while taking sulfonylureas tell your healthcare provider immediately so the right medications can be prescribed.

People with type 1 diabetes.

How will I know if it is working?

Check your blood glucose at the times specified by your healthcare provider. If your blood glucose or A1C is within target most of the time, the dose is working. If not, review the amount and types of food eaten or if you have forgotten to take the prescribed dose of your medication. If blood glucose remains high, contact your healthcare provider. A change in dose may be needed.

New medications

Other new medications that work very similar to sulfonylureas by helping the pancreas make more insulin are:

Prandin® (repaglinide)

Starlix® (nateglinide)

These medication can also cause hypoglycemia. One advantage of taking these is that if a meal is skipped, the dose can be skipped.